替罗非班对ACI支架取栓治疗及脑灌注异常区CT灌注成像结果的影响

doi:10.7517/issn.1674-0475.220319

摘要/Abstract

摘要： 本研究观察替罗非班对急性脑梗死（ACI）支架取栓患者抗血小板功能及脑灌注异常区CT灌注成像（CTPI）结果的影响。选取100例ACI患者，根据入院顺序采用简单随机法均分为两组。对照组给予支架取栓治疗，观察组给予替罗非班联合支架取栓治疗。比较两组血管再通情况、不良事件发生情况，检测两组脑灌注异常区CTPI结果、凋亡分子[半胱氨酸蛋白酶-3（Caspase-3）、凋亡蛋白（Bax）]、血小板功能指标（血小板黏附率、血小板聚集率）的变化。观察组TICI分级2b级和3级共40例，血管再通率为80.00%，对照组TICI分级2b级和3级共31例，血管再通率为62.00%，观察组的血管再通率高于对照组（P<0.05）。两组脑灌注异常区相对脑血流量（rCBF）、相对脑血容量（rCBV）与治疗前比较均升高（P<0.05），相对平均通过时间（rMTT）、相对达峰时间（rTTP）与治疗前比较均下降（P<0.05）；观察组治疗后脑灌注异常区rCBF、rCBV高于对照组，rMTT、rTTP低于对照组（P<0.05）。两组的Caspase-3、Bax、血小板黏附率、血小板聚集率与本组治疗前比较下降（P<0.05），观察组治疗后凋亡分子、血小板功能指标均低于对照组（P<0.05）。观察组不良事件发生率为4.00%，低于对照组的16.00%（P<0.05）。替罗非班可改善ACI支架取栓患者脑灌注异常区的脑血流动力学，且抗血小板功能较好，不良事件发生率低。

关键词: 替罗非班, 急性脑梗死, 支架取栓, 抗血小板功能, CT灌注成像

Abstract: This study observed the effect of tirofiban on the antiplatelet function and CT perfusion imaging (CTPI) results of patients with acute cerebral infarction (ACI) stent thrombus removal. 100 patients with ACI were randomly divided into two groups according to the admission order. The control group was treated with stent thrombectomy, and the observation group was treated with tirofiban combined with stent thrombectomy. Compared the vascular recanalization and adverse events between the two groups. The changes of CTPI results, apoptotic molecules[Caspase-3, apoptotic protein (Bax)] and platelet function indexes (platelet adhesion rate and platelet aggregation rate) were detected. There were 40 cases in the observation group with TICI grades 2b and 3, and the vascular recanalization rate was 80.00%, while in the control group, there were 31 cases in the TICI grades 2b and 3 (the vascular recanalization rate was 62.00%). The vascular recanalization rate was higher than in the control group (P<0.05). Compared with pre-therapy the relative cerebral blood flow (rCBF) and relative cerebral blood volume (rCBV) in cerebral perfusion abnormal areas in the two groups were both increased (P<0.05), while the relative mean transmit time (rMTT) and relative time to peak (rTTP) were both decreased. After treatment, rCBF and rCBV in cerebral perfusion abnormal areas in the observation group were higher than those in the control group, and rMTT and rTTP were lower than those in the control group (P<0.05). The Caspase-3, Bax, platelet adhesion rate and platelet aggregation rate in the two groups were decreased than those before treatment in the same group (P<0.05). After treatment, the apoptosis molecules and platelet function indexes in the observation group were lower than those in the control group (P<0.05). The incidence of adverse events in the observation group was 4.00%, which was lower than 16.00% in the control group (P<0.05). Tirofiban can improve the cerebral hemodynamics in the cerebral perfusion abnormal area of patients with ACI stent thrombectomy with good antiplatelet function and low incidence of adverse events.

Key words: tirofiban, acute cerebral infarction, stent thrombectomy, antiplatelet function, CT perfusion imaging

王峥, 姜红梅. 替罗非班对ACI支架取栓治疗及脑灌注异常区CT灌注成像结果的影响[J]. 影像科学与光化学, 2022, 40(5): 1072-1076.

WANG Zheng, JIANG Hongmei. Effect of Tirofiban on ACI Stent Thrombectomy and CT Perfusion Imaging in Cerebral Perfusion Abnormal Area[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(5): 1072-1076.

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